Pandemics

PANDEMICS

A pandemic is the worldwide spread of a new disease.An influenza pandemic occurs when a new influenza virus emerges and spreads around the world, and most people do not have immunity. 

Viruses that have caused past pandemics typically originated from animal influenza viruses.
Some aspects of influenza pandemics can appear similar to seasonal influenza while other characteristics may be quite different. For example, both seasonal and pandemic influenza can cause infections in all age groups, and most cases will result in the person recovering fully without treatment. However, typical seasonal influenza causes the most deaths among the elderly while other severe cases occur most commonly in people with a variety of medical conditions.

By contrast, the H1N1 pandemic caused most of its severe or fatal disease in younger people, both those with chronic conditions as well as healthy persons. It also caused many more cases of viral pneumonia than is normally seen with seasonal influenza.

In case of both seasonal and pandemic influenza, the total number of people who get severely ill can vary. However, the impact or severity tends to be higher in pandemics partly because of the much larger number of people in the population who lack pre-existing immunity to the new virus. In case of both seasonal and pandemic influenza, the highest levels of activity is expected to occur in the usual influenza season for an area. (In the temperate climate zones, this is usually the winter months). 

In the case of H1N1 pandemic, there were large outbreaks in the summer. Below listed are a few pandemics that occurred in the past:

• HIV/AIDS PANDEMIC (AT ITS PEAK, 2005-2012)
• FLU PANDEMIC (1968)
• ASIAN FLU (1956-1958)
• FLU PANDEMIC (1918)
• SIXTH CHOLERA PANDEMIC (1910-1911)
• FLU PANDEMIC (1889-1890)
• THIRD CHOLERA PANDEMIC (1852–1860)
• THE BLACK DEATH (1346-1353)
• PLAGUE OF JUSTINIAN (541-542)
• ANTONINE PLAGUE (165 AD)

Historical data indicates that there is no set global trend in case of occurrence of pandemics. Pandemics occur randomly and in a staggered fashion throughout the globe. However, whenever they occur, they ensure severe financial and human resource loss. Whenever pandemics occur, they have shown an increasing trend in terms of losses.

R&R_st_ctr_othrStkHldr

ROLES AND RESPONSIBILITIES OF STATE, CENTRE & OTHER STAKEHOLDERS IN DISASTER MANAGEMENT

Roles & Responsibilities of state in disaster management

1. The State Disaster Management Authority (SDMA) is set up under the chairmanship of chief minister.
2. The responsibility of rescue, relief and rehabilitation lies with the state government.
3. When the calamity is of a severe nature and the Calamity Relief Fund (CRF) is not sufficient the states may approach the central government for additional assistance from the National Calamity Contingency Fund (NCCF).
4. Work is delegated to the relief commissioner who is in-charge of relief and rehabilitation measures. He functions under the directive of the state level committee.
5. Below the state government is the district level disaster management authority (DDMA) which is responsible for actual  the ground work relief. The district magistrate, district collector and deputy commissioner coordinate and supervise the relief work.
6. The district disaster management committee comprising of officers from health, irrigation, veterinary, police, fire services, water and sanitation takes decisions on relief measures and these decisions are carried out by the disaster management team.
   

Roles & Responsibilities of centre in disaster management

1. The central government supplements the efforts of the state government by providing financial and logistic support in case of major disasters.
2. Depending on the gravity of the situation, the centre decides the scale of operations.
3. All natural disasters are coordinated by the ministry of home affairs. Only drought is taken care of by the ministry of agriculture
4. Different types of man-nade disasters are handled by the respective central government ministries. For example - Air accidents are handled by ministry of civil aviation, railway accidents are handled by ministry of railways, chemical, biological and nuclear disasters are handled by ministry of home affairs and epidemics are handled by ministry of health and family affairs.
5. The prime minister, ministers of the union cabinet and the National Crisis Management Committee are collectively responsible for the decisions taken for disaster management.

Roles & Responsibilities of other stakeholders in disaster management
Other stakeholders refers to people or entities who have a financial interest. They can be affected by actions, objectives and policies. Some examples of stakeholders are creditors, company directors, employees, owners (shareholders), suppliers and unions from which the business draws its resources. The stakeholders may be internal (employees, manager, owner) or external (Suppliers, Society, Government, Creditors, Shareholders, Customers). When a disaster strikes an area causing extensive damage to private company buildings and or manufacturing industries, the stakeholders have a few roles and responsibilities as listed below-

1. The stakeholders should engage in contingency planning taking worst case scenario under consideration
2. Disaster Risk Management (DRM) present mechanisms for emergency coordination that should be practiced/rehersed for familiarity with the role and processes to be followed
3. Communication, Interoperability and Interagency coordination are critical and essential to everyday Disaster Risk Management (DRM)
4. Each stakeholder has responsibilities in different phases of disaster
5. Stakeholders promote disaster prevention and mitigation using a risk-based and all-hazards approach
6. The community is the most important stakeholder in the disaster management process
7. Mock drills and exercises for different disasters are essential for role clarity of stakeholders and for synergising coordination of various emergency support functions
8. Coordination of efforts amongst various government departments and stakeholders generates synergy and involves bringing together agencies and functionaries to ensure effective performance

R&R of community

ROLES AND RESPONSIBILITIES OF COMMUNITY IN DISASTER MANAGEMENT

The community that faces a disaster should be a part of the complete disaster management process. The community knows its environment better than anyone else. Additionally, senior citizens will be aware of incidents that had occurred in the past. The community should be made aware of its history with respect to disasters along with providing necessary inputs to identify hazards and risks. The responsibilities of the community towards disaster management are listed below-

1. Engage in public awareness campaigns about disasters.
2. In case of any disaster, the community should act as the first responder before external help reaches the victims. This will reduce the work load on external agencies coming to help
3. Communities should be responsible to raise public awareness and bring about a behavioural change in disaster preparedness and mitigation
4. Communities should be responsible for deployment of stable, reliable and effective warning systems
5. It is the responsibility of the community to partner with media (radio & TV) in improving disaster awareness
6. The community is responsible for communicating and disseminating disaster warning to vulnerable people and set-up a community emergency operations centre (EOC).
7. Community Disaster Response Team (CDRT) is responsible for strengthening the existing role of District Emergency Organization (DEO)
8. Capacity building at social, economic and environmental levels

The roles of the community towards disaster management are listed below-

1.  Training
2. Planning
3. Early warning
4. Communication
5. Shelter
6. Search and rescue
7. Arrangement of food
8. Set-up of Public Distribution Centres
9. Set-up cultural groups to engage in awareness to build disaster preparedness
10. Fire prevention 
11. Initial damage assessment
12. Shelter management
13. Psychosocial support

Role of Urban Local Bodies in Disaster Management

ROLE OF URBAN LOCAL LOCAL BODIES IN DISASTER MANAGEMENT

Urban local bodies refers to governance of an urban area by the people through their elected representatives. The tenure of urban local self-governing bodies is fixed at five years. Urban Local Bodies (ULBs) play a very important role in planning and development of urban areas. Urban local bodies form an important stakeholder at the town level. Urban Local Bodies are classified into four major categories

1. Municipal corporation
2. Municipality
3. Town area committee and
4. Notified area committee

 Urban Local Bodies are not well equipped both administratively and financially to mitigate any natural or man-made hazard. They require help from the state government to deal with any hazard. Urban Local Bodies have the highest stake in disaster mitigation but have the least power in administrative hierarchy.  In December 2005, the prime minister launched the Jawaharlal Nehru National Urban Renewal Mission(JNNURM) to provide assistance to state governments and Urban Local Bodies. ULB's perform analysis of the city's susceptibility to floods, earthquakes and other disasters.

The role of Urban Local Bodies (ULBs) in disaster management is to-

1. develop, review and assess effective disaster management practices
2. help local goverment to prepare a local disaster management plan and
3. ensure the community knows how to respond in a disaster.

Heat Waves

HEAT WAVES

• Heat wave is defined as a period of excessively hot weather coupled with excessive humidity.
• A heat wave occurs when there are a number of consecutive days with high temperature that the body cannot tolerate
• A a result of heat wave animals and plants suffer from 'heat stress'.
• Human beings suffer from sunstroke, severe dehydration with vomiting, fever and ultimately die.
• Based on physical meteorological perspective, heat-wave events can be classified into 
• Dry heat wave
• Dry heat-waves are characterised by dry weather conditions with clear skies and large inputs of solar radiation
• Windy conditions can increase the heat stress
•  Dry heat waves usually occur where air is warmed adiabatically
• Moist heat waves
• They are characterized with  very warm, oppressive conditions throughout the day and night
• They normally occur under a cloud cover at night which prevents loss of accumulated heat during the day
• Such heat waves are a feature of mid-latitude temperate

• A heat wave is caused by a system of high atmospheric pressure
• In a high pressure system, air from upper levels of the atmosphere descends and rotates outward
• As it comes down, it becomes compressed, which increases the temperature

The following are the effects of a heat wave on the human body

1. Headaches
2. Muscular cramps
3. Swollen hands, feet and ankles
4. Appearance of heat rash on the skin
5. Unusual fatigue
6. General discomfort
7. Signs of dehydration like
1. Excessive thirst
2. Less frequency of urination
3. Dark urine
4. Dark skin
5. Rapid pulse and breathing

 Medical intervention is required in the following situations

1. Difficulty breathing
2. Convulsions
3. Deterioration of consciousness
1. Confusion
2. Unusual behaviour
3. Agitation
4. Hallucination
5. Lack of response to external stimuli
4. Loss of consciousness

Heat stroke is the most serious effect of heat. It can occur suddenly and quickly leas to death if not treated quickly. Signs of heat stroke are

1. Oral temperature more than 39.5 C and rectal temperature more than 40 C
2. Dry skin, hot and red 
3. Dizziness and vertigo
4. Confused and illogical speech
5. Aggressive or strange behaviour 
6. General discomfort

Role of PRi in Disaster Management

ROLE OF PANCHAYAT RAJ INSTITUTIONS (PRIs) IN DISASTER MANAGEMENT 

 The PRi is a statutory body elected by the local people through a well defined democratic process with specific responsibilities and duties. Elected members are accountable to the people of the ward, rural community, block and the district. The PRIi being a representative body of the people, is the most appropriate institution from the village to the district level in view of its proximity, universal coverage and enlisting people's participation on an institutionalized basis. Their close involvement is crucial in getting people prepared for countering natural disasters as well as involving people in all possible preventive and protective activities so that the impact of the disasters are mitigated and the people save their lives and property. PRis act as catalysts to social mobilization process an tap the traditional wisdom of local communities to complement modern practices in disaster mitigation efforts. PRis also provide a base for integration of various concerns of the community that of NGOs and CBOs that are engaged in various developmental activities at the grassroots level. If PRi's are not consulted for preparedness, planning, relief and rehabilitation work, it leads to lack of accountability and transparency resulting in loss of money.

Activities like distribution of immediate relief in the form of money, food grains, medical care, clothes, tent, vessels, drinking water and other necessities, activities of restoration, rehabilitation and reconstruction efforts of damaged villages and towns can be implemented better with the involvement of local bodies. PRi plays a crucial role in mobilizing people in various situations of crisis. The impact of disasters on people living in vulnerable areas and losses to their property can be minimized by a pro-active role played by PRis at the grassroots level. PRi members can play a role of leadership in disaster management at all stages.
Role played by PRis at various levels of disaster management is given below:

PRE-DISASTER
-Organizing awareness campaigen and promoting community education on disaster preparedness
-Articulation of community need for developing preparedness plan through community involvement and panchayat ownership
-Identifying the resource gaps both physical and manpower and replenish the same through capacity building
-Establishing synergy with local agencies including NGOs / CBOs
-Dovetailing risk reduction into various development programs of national and state governments
-Establish convergence with local institutional structures created for implementing education, health, livelihood, social justice, etc
-Activating the disaster management plans with the participation of the community
-Formation of task forces and their capacity building

DURING DISASTER
-Arranging emergency communication through available resources
-Evacuation to temporary shelter and running relief camps
-Supplementing rescue and relief efforts in coordinating different agencies
-Monitoring of relief distribution
-Safe disposal of carcass along with setting sanitation facilities and safe drinking water

POST DISASTER
-Damage assessment particularly assisting in identifying victims for compensation and its distribution
-Formulating rehabilitation and reconstruction plan of houses and other local infrastructure
-Enforce minimum specification for safe reconstruction
-Supervise and monitor long term reconstruction and mitigation projects
-Mobilising special funds to use disaster resistant construction technology in vulnerable areas.

Community Based DRR

COMMUNITY BASED DISASTER RISK REDUCTION

 

Community Based  Disaster Risk Reduction refers to locally appropriate and locally "owned" strategy for disaster preparedness and risk reduction.This has been designed to improve the effectiveness of specialist and non-specialist professionals in disaster response, helping them to link the disasters with risk reduction and development in a sustainable manner.

Communities are at the core of disaster risk reduction (DRR), and community based approaches are getting increasing focus in national DRR plans.

Reducing the risk and losses of disasters is a collective effort. It requires collective action.

Without engagement at the local level, it’s very difficult to cope with any disaster.

The following factors determine the success of a  Community Based  Disaster Risk Reduction (CBDRR) program:

1. Motivation and capacity of the community and community leaders
2. Motivation and capacity of community and the stakeholders coupled with the strength of partnerships between them
3. The capacity of external agencies and the strength of partnership with them
4. The level of community participation and ownership of the CBDRR program
5. The level of integration of CBDRR programs with other sectors
6. Maintaining an appropriate balance between standardisation and flexibility in terms of program design
7. Time constraints to implement CBDRR programs
8. Availability of funds to implement CBDRR programs
9. Presence of adequate assessment, monitoring and evaluation procedures

Community based Disaster Risk Reduction (CBDRR) is the core of any risk reduction program as communities are the first responders to any disaster. Disaster Risk Reduction focuses on reducing the underlying risk and encourages preventive action before a disaster. Communities become actively involved in search and rescue, relief and post-disaster recovery. CBDRR emerged as a result of shift from reactive emergency management to disaster risk reduction. In order to enhance community participation in before a disaster occurs, it is important to focus on risk reduction issues. This led to development of Community based Disaster Risk Reduction (CBDRR) . CBDRR focuses on predisaster interventions such as prevention, mitigation and preparedness related activities. Prevention aims at avoiding the occurrence of disasters. While this is not possible in the case of natural disasters, the intensity and frquency can be reduced by
-poverty alleviation
-asset redistribution plans
-provision of basic services such as education and health care
Mitigation measures reduce and limit the impact  of natural hazards on elements of risk such as population, infrastructure and properties through structural measures such as bridges, protective dykes, embankments and safety building design. Non-structural measures include community risk assessment, community risk reduction planning, public awareness, food security programs, group savings, cooperatives, strengthening community disaster management organizations and advocacy on disasters and development issues, legislation, land use zoning, etc. Disaster mitigation is an essential component of sustainable development. The essential elements and features of CBDRR form the core of community based approaches for disaster risk reduction. They are
-People's participation
-Setting priorities for the most vulnerable groups, families and people in the community
-Community-specific risk reduction measures
-Recognition of existing capacities and coping mechanisms
-Understanding the link between disaster risk reduction and development
-Supporting and facilitating role of exterternal (non-government) agencies

Community based approaches can be defined as a broad coverage of approaches that involve beneficiaries in their identification, design and management. It also refers to a collection of approaches applied within community level projects or as part of national programs. It also varies from consultation with communities to decision making to devolution of resources at the community level.
Community based disaster risk reduction is important since
-People in the community are the ultimate sufferers
-The people of the community are the first responders who have an in-depth knowledge of the area
-External help take time to arrive at the area
-It has been proved that top-down disaster risk management and response programs fail to address specific local needs of vulnerable communities and ignore the potential of local resources.
-The top-doen disaster risk management approach may also increase people's vulnerability

CBDRR is a process in which risk communities are actively engaged in identification, analysis, treatment, monitoring and evaluation of disaster risks in order to reduce their vulnerabilities and enhance capacities. People are at the heart of decision making and implementation of disaster risk reduction activities.

Analysis of disaster management lifecycle

ANALYSIS OF THE DISASTER MANAGEMENT CYCLE

Disaster management aims to reduce, or avoid, the potential losses from hazards, assure prompt and appropriate assistance to victims of disaster, and achieve rapid and effective recovery. The Disaster management cycle illustrates the ongoing process by which governments, businesses, and civil society plan for and reduce the impact of disasters, react during and immediately following a disaster, and take steps to recover after a disaster has occurred. Appropriate actions at all points in the cycle lead to greater preparedness, better warnings, reduced vulnerability or the prevention of disasters during the next iteration of the cycle. The complete disaster management cycle includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure.
The mitigation and preparedness phases occur as disaster management improvements are made in anticipation of a disaster event. Developmental considerations play a key role in contributing to the mitigation and preparation of a community to effectively confront a disaster. As a disaster occurs, disaster management actors, in particular humanitarian organizations, become involved in the immediate response and long-term recovery phases. The four disaster management phases need not necessarily occur in isolation or in this precise order. Often phases of the cycle overlap and the length of each phase greatly depends on the severity of the disaster.

• Mitigation - Minimizing the effects of disaster.
  Examples: building codes and zoning; vulnerability analyses; public education.
• Preparedness - Planning how to respond.
  Examples: preparedness plans; emergency exercises/training; warning systems.
• Response - Efforts to minimize the hazards created by a disaster.
  Examples: search and rescue; emergency relief .
• Recovery - Returning the community to normal.
  Examples: temporary housing; grants; medical care. 

Mitigation
Mitigation activities actually eliminate or reduce the probability of disaster occurrence, or reduce the effects of unavoidable disasters. Mitigation measures include building codes; vulnerability analyses updates; zoning and land use management; building use regulations and safety codes; preventive health care; and public education.
Mitigation will depend on the incorporation of appropriate measures in national and regional development planning. Its effectiveness will also depend on the availability of information on hazards, emergency risks, and the countermeasures to be taken. The mitigation phase, and indeed the whole disaster management cycle, includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure.
 
Preparedness
The goal of emergency preparedness programs is to achieve a satisfactory level of readiness to respond to any emergency situation through programs that strengthen the technical and managerial capacity of governments, organizations, and communities. These measures can be described as logistical readiness to deal with disasters and can be enhanced by having response mechanisms and procedures, rehearsals, developing long-term and short-term strategies, public education and building early warning systems. Preparedness can also take the form of ensuring that strategic reserves of food, equipment, water, medicines and other essentials are maintained in cases of national or local catastrophes.
During the preparedness phase, governments, organizations, and individuals develop plans to save lives, minimize disaster damage, and enhance disaster response operations. Preparedness measures include preparedness plans; emergency exercises/training; warning systems; emergency communications systems; evacuations plans and training; resource inventories; emergency personnel/contact lists; mutual aid agreements; and public information/education. As with mitigations efforts, preparedness actions depend on the incorporation of appropriate measures in national and regional development plans. In addition, their effectiveness depends on the availability of information on hazards, emergency risks and the countermeasures to be taken, and on the degree to which government agencies, non-governmental organizations and the general public are able to make use of this information.

Response
The aim of emergency response is to provide immediate assistance to maintain life, improve health and support the morale of the affected population. Such assistance may range from providing specific but limited aid, such as assisting refugees with transport, temporary shelter, and food, to establishing semi-permanent settlement in camps and other locations. It also may involve initial repairs to damaged infrastructure. The focus in the response phase is on meeting the basic needs of the people until more permanent and sustainable solutions can be found. Humanitarian organizations are often strongly present in this phase of the disaster management cycle.
 
Recovery
As the emergency is brought under control, the affected population is capable of undertaking a growing number of activities aimed at restoring their lives and the infrastructure that supports them. There is no distinct point at which immediate relief changes into recovery and then into long-term sustainable development. There will be many opportunities during the recovery period to enhance prevention and increase preparedness, thus reducing vulnerability. Ideally, there should be a smooth transition from recovery to on-going development.
Recovery activities continue until all systems return to normal or better. Recovery measures, both short and long term, include returning vital life-support systems to minimum operating standards; temporary housing; public information; health and safety education; reconstruction; counseling programs; and economic impact studies. Information resources and services include data collection related to rebuilding, and documentation of lessons learned.

Disaster Cycle

The disaster life cycle includes several phases:

• Mitigation: Disaster mitigation work involves directly preventing future emergencies and/or minimizing their negative effects. It requires hazard risk analysis and the application of strategies to reduce the likelihood that hazards will become disasters, such as flood-proofing homes or buying insurance. 

 

• Disaster preparedness: Disaster preparedness efforts include plans or preparations made in advance of an emergency that help individuals and communities get ready. Such preparations might include the stocking of food and water, or the gathering and screening of willing volunteers.

 

• Disaster response: Disaster response work includes any actions taken in the midst of or immediately following an emergency, including efforts to save lives and to prevent further property damage. Ideally, disaster response involves putting already established disaster preparedness plans into motion. Typically, this phase of the disaster life cycle draws the most attention.

 

• Disaster recovery: Disaster recovery happens after damages have been assessed, and involves actions to return the affected community to its pre-disaster state or better – and ideally to make it less vulnerable to future risk. Risk identification includes understanding the nature of hazards as well as understanding the nature of vulnerabilities. Subsequent efforts may range from physical upgrades to education, training, and public awareness campaigns.

This is depicted diagrammatically below:

culture of safety

CULTURE OF SAFETY:

Safety ofpeople in a community depends on several factors such as; training, and the systems, protocols and technology in place to prevent incidents from becoming disasters. This concept should
be deeply important as a community wide culture of safety. In order to improve the culture of safety in a community, major disasters in the past should be analysed in the contestxt of safety.
Thus, culture of safety is defined as "the individual and group values, attitudes and patterns and behaviour determine the commitment to, style and efficiency of a community's health and safety program"
It was found that tolerance of inadequate systems was thew most common cause of failures; as well as acceptance of deviance, production pressure and complacency. Experrs in the field of safety
propound that "it is not possible to be safe without a supporting culture and that "improvement in safety performance is only possible by improving or establishing a culture of safety". Culture of safety
can be brought about by introducing:

• Safety Culture Improvement tool and
• Safety culture metrics.

Safety culture improvement tool involves an audit of the health and safety management systems currently in place and suggest ways to improve these systems
Safety culture metrics focusses on quality of safety activities rather than the quantity and compares current activities to those of an earlier time frame

Culture of safety cannot be  measured with any level of precision but can be assessed.
Metrics have been developed to enable leaders to track the things they do on a day-to-day basis and identify areas with weakest performance. Experts recommend that basic safety training should be imparted to workers and employees and establish a culture of safety at the workplace and thus minimize
the occurrence of accidents. The fundamental objective of having a culture of safety  not only enhances working environment but also increases the overall productivity. It should be the the aim of every 
industrialist to use safe industrial equipment and products along with providing a safe working environment to his employees.

QUIZ-I

QUIZ-I

Covering Unit-I & Unit-II

Answer ALL

1. A disaster is a __________, ____________ event that seriously disrupts the functioning of a community or society and causes __________, ___________, and _____________ or environmental losses that exceed the ________________ or _____________ ability to cope using its own resources
2. List four examples of natural disasters
3. How can the impact of disasters be minimized
4. Define disaster, Hazard and the three components of vulnerability
5. What is risk and express risk as a formula
6. List two examples of man-made disasters
7. List the various impacts of droughts
8. List the indirect effects of drought
9. List the negative effects of drought on people. 
10. List the economic impacts of drought
11. Explain briefly, the political impact of drought as a "focussing event".
12. List few environmental impacts of droughts
13. List the various impacts (six typical and ten delayed) of drought on the health of a community
14. List the various disasters that the Indian subcontinent and the northern himalayan region are prone to
15. What percentage of India is prone to drought, earthquake, floods and cyclones.
16. List the various major famines in India
17. What is the average drought frequency in India
18. Who are the worst affected by droughts
19. What are the two broad classifications of disasters in India
20. What is the meaning of Hydrometeorology and list examples of hydrometeorological disasters
21. What are geological disasters also known as 
22. List examples of geological disasters
23. List the common characteristics of natural disasters
24. State the conceptual and operational definitions of drought
25. List the various types of drought
26. List the causes of drought
27. List the various direct and indirect impacts of drought
28. List the economic, environmental and social impacts of drought
29. What is the impact of drought on the health of a community
30. List the initial and delayed responses with regard to psychosocial impacts of drought on people in the affected community
31. Explain in brief the phrase, "differential impacts of disasters"
32. What is meant by "global trends"
33. List the factors contributing to an increasing trend in number of disasters over the past few decades
34. What is an urban disaster
35. Define pandemics
36. List the four types of stability found in complex emergencies
37. List the factors contributing to rapid climate change
38. Why are slums in cities a major center of crime
39. List the reasons for high hazard intensity in urban areas
40. List examples of pandemics that occurred in the past
41. List the characteristics of complex emergencies
42. List the effects of national and international level complex emergencies
43. List the various climate change indicators
44. List the various risks due to climate change
45. List the direct and indirect impacts due to climate change
46. List the impacts that climate change has on ecosystems and environmental relationships
47. List the various causes due to floods and cyclones
48. Where are tropical cyclones generated
49. What is the 'eye' of a cyclone
50. What is the wind direction in a cyclone
51. What is an 'eye wall' and a 'rain band' in a cyclone
52. What causes 'local storms'
53. List the primary, secondary and tertiary hazards due to a cyclone with examples
54. List the damage caused due to local storms
55. Define atmospheric hazards. What are they also known as 
56. What is a cumulative atmospheric hazard
57. List the various atmospheric hazards
58. List the common types of toxic gases encountered in confined spaces
59. Define a cold wave and list the criteria for determining a cold wave
60. List the effects of cold waves
61. Can cold waves be forecasted
62. Define heat wave and heat stress
63. On what basis are heat waves classified
64. List the characteristics of dry heat wave and moist heat wave
65. List the effects of heat wave on the human body
66. List the signs of heat wave
67. ___________% of rainfall occurs in ___________ months in India
68. Define flood
69. Floods in India are caused due to _________________________ basin that carries ___% of total river flow in India
70. List the various causes of floods in India
71. List the various flood prone regions of India
72. Define a road accident
73. List the various causes of traffic accident
74. List the elements of good driving
75. List the effects of a traffic accident